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Biomedical subjects

P Enblad

Publications and source records attributed to P Enblad.

63 records · Page 4Linked to original sources
PubMed1984

Recurrent rectal carcinoma after anterior resection and rectal stapling.

Nine local recurrences have been diagnosed in 38 patients with carcinoma of the rectum operated on with anterior resection using the EEA-stapling instrument. The characteristics of these recurrences have been compared with those of other authors, currently a total of 27 recurrences. The presence of a locally advanced growth with extramural spread, a distal location and a short margin of clearance seems to increase the risk of local recurrence, with often distressing symptoms. It is proposed that even if the EEA-stapler offers technical possibilities for anterior resection in these growths, this operation should be restricted to less advanced tumours.

Aged↗
PubMed1983

The EEA-stapling device in anterior resection for carcinoma of the rectum. Technique and early recurrences.

The EEA-autostapling device was used for the anastomosis in 34 patients operated upon with anterior resection for carcinoma of the rectum. The lower border of the tumours was located between 6 and 20 cm from the anal verge and the distal margin free of tumour in the resected specimen was 4 cm (1-8 cm). The anastomoses were within 10 cm from the anal verge in 27 patients. Technical problems occurred in two patients. Eight cases showed incomplete tissue rings but anastomotic leakage was noted merely in four patients (12%). Wound infections were rare (6%). According to Dukes' classification the material comprised 15% Dukes' A, 32% Dukes' B. 38% Dukes' C and 15% Dukes' D. The patients were followed with clinical examinations, rectal palpation and sigmoidoscopy every 3-6 months after the operation. Early local recurrence (median value 5 months) was diagnosed in seven patients (21%). They had in common tumour in the lower part of the rectum, extramural spread and a short distal margin free of tumour. Three of these were classified as Dukes' D, three as Dukes' C and one as Dukes' B. It is concluded that early local recurrence after anterior resection may be due to local tumour spread but a decreased circular radicality may be another reason. The results demonstrate the need to define patients who might be treated by an abdomino-perineal excision even if the EEA-stapler makes a low rectal anastomosis possible.

Aged↗
PubMedDate not supplied

Early outcome after emergency and elective surgery for ulcerative colitis.

The early outcome after surgical treatment of ulcerative colitis was retrospectively analyzed in 185 patients. The operation was performed on emergency indications in 25 cases, and was subacute in 53 and elective in 107. The postoperative mortality was 7% overall, 24% in the emergency group, 8% in the subacute group and 2% in the elective group. At least one early postoperative complication occurred in 71 (38%) of the 185 patients (92%, 38% and 26% in the respective groups). Infection was the predominant problem, occurring in 26% of the patients. The mortality was highest after colectomy and ileostomy, but this procedure was used in the most sick patients. Proctocolectomy was associated with the highest morbidity in all groups, whereas colectomy and ileorectal anastomosis carried no mortality and little morbidity.

Adult↗
PubMedDate not supplied

The DNA content in rectal adenomas.

Flow cytometric DNA analysis was performed in 67 tubular, tubulovilous and villous rectal adenomas with different degree of dysplasia. One of the adenomas contained a focus of early invasive carcinoma. All but one of the 67 adenomas had near diploid DNA histograms; the exception was a tubular adenoma with severe dysplasia but without signs of early invasion. Flow cytometric DNA analyses of adenomas may in some cases provide valuable information. The low frequency of aneuploidy indicates, however, that routine DNA measurements are questionable. Rather, the analysis should be restricted to certain cases like those with high malignant potential, cases with suspected early invasive carcinoma, and adenomas not radically removed.

Adenoma↗
PubMedDate not supplied

Acute solitary diverticulitis of the caecum. Case report.

In two cases of suspected appendicitis, laparotomy revealed an inflammatory mass medially in the caecum. Colonic resection was performed in both cases and the final diagnosis was solitary caecal diverticulitis. When inflammation of a caecal diverticulum is recognized at laparotomy, simple diverticulectomy is the procedure of choice, but colonic resection is recommended if malignancy cannot be excluded or inflammatory changes are severe.

Acute Disease↗
PubMedDate not supplied

Surgery for colorectal cancer in elderly patients.

In 545 consecutive patients undergoing elective or emergency surgery for colorectal cancer (370 colon and 175 rectum), mortality and morbidity were analysed in different age groups with special reference to patients over 80 years old. In that group, 33% had an emergency operation, compared with 18% below that age. Postoperative mortality after elective surgery ranged from 3 to 11% in the different age groups, but was not significantly related to age. In contrast, postoperative in-hospital mortality after emergency surgery was high (38%) among those older than 80 years, compared with 6% below 75 years and 24% between 76 and 80 years. Postoperative morbidity, i.e. infections and cardiovascular disease, increased with age, as did the length of hospital stay. Five-year survival, independent of age, was poorer after emergency surgery than after elective surgery. It is concluded that elective colorectal resection for cancer in elderly patients is a safe procedure.

Adult↗
PubMedDate not supplied

The prognostic significance of DNA content in carcinoma of the rectum and rectosigmoid.

Using cytofluorometric single-cell DNA analysis, the pattern of nuclear DNA content was determined in preoperative biopsies from 166 unselected primary adenocarcinomas of the rectum or rectosigmoid. The pattern was aneuploid (AN) in 125 (75%) of the tumours, was aneuploid (AN) in 125 (75%) of the tumours, near-diploid with aneuploid cells (ND-anc) in 26 (16%) and near-diploid (ND) in 15 (9%). The DNA content was not related to tumour stage or degree of differentiation. The clinical course tended to be more favourable in patients with ND tumour than in those with AN or ND-anc pattern. The nuclear DNA content in rectal carcinoma thus can be estimated in preoperative biopsies, and the pattern may serve as a prognostic parameter.

Adenocarcinoma↗
PubMedDate not supplied

Comparative immunohistochemical demonstration of difucosylated carbohydrate antigens and CEA in adenomas and carcinomas of the rectum and rectosigmoid.

The present immunohistochemical investigation reveals that difucosylated carbohydrate antigens (DFCA) are extensively expressed in rectal and rectosigmoid carcinomas while normal mucosa and hyperplastic polyps are mainly negative. The adenomas showed intermediate staining patterns where adenomas with villous structures and moderate-severe dysplasia resembled of carcinomas. CEA was more extensively expressed in both normal, premalignant, and malignant tissue. Thus, DFCA is better than CEA as a discriminator between normal and malignant tissue in the distal large bowel, and may be used in future studies with the intention of advancing our understanding of the neoplastic process and assessing clinical relevance.

Adenoma↗